Analysis of the position of the left ventricular apex and base during systole

Nogueira, Eduardo Arantes; Carvalhal, S; MacMillan, Robert M.; Maranhão, Vladir

doi:10.1002/ccd.1810130406

Cited by 8 publications

(2 citation statements)

References 32 publications

(25 reference statements)

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“…In previous studies we showed that the left ventricular base descends in the direction of the cardiac apex and that the apex stays almost stationary during systole. 32 In this context, if we imagine the heart to be divided into several segments in a longitudinal direction from base to apex, longitudinal movement of the base would be a summation of the excursion of each of these segments in a longitudinal direction and would thus represent global systolic performance. In this model each segment would add an equal share of contraction, irrespective of whether it is a basal segment or an apical segment.…”

Section: Possible Limitationsmentioning

confidence: 99%

Assessment of right ventricular function with Doppler echocardiographic indices derived from tricuspid annular motion: comparison with radionuclide angiography

Ueti

2002

Heart

239

174

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Objective: To assess right ventricular systolic function using indices derived from tricuspid annular motion, and to compare the results with right ventricular ejection fraction (RVEF) calculated from radionuclide angiography. Design: Pulsed Doppler echocardiography indices were obtained from 10 patients with a normal RVEF (group 1) and from 20 patients whose RVEF was less than 45% (group 2). Results: The patients in the two groups were similar in age, systolic blood pressure, and heart rate. There was a close correlation between the tricuspid annular motion derived indices (D wave integral (DWI), peak velocity of D wave (PVDW), and tricuspid plane systolic excursion (TPSE)) and RVEF (r = 0.72, 0.82, and 0.79, respectively). DWI was significantly higher in group 1 than in group 2. PVDW discriminated adequately between individuals with abnormal and normal right ventricular ejection fraction. The sensitivity and specificity of tricuspid annular motion derived indices were very good. Conclusions: Indices derived from tricuspid annular motion appear to be important tools for assessing right ventricular systolic function.A ssessment of the right ventricular ejection fraction (RVEF) is difficult owing to the complex structure and asymmetrical shape of the ventricle. 1 In contrast to the left ventricle, the right ventricular cavity does not resemble a clear tridimensional geometrical solid to serve as a model for calculations. 1-5The ejection fraction calculated from radionuclide angiography is independent of a geometrical model and has become the standard method for determining right ventricular systolic function. 6 Cross sectional echocardiography has been widely used for determining left ventricular function, though its role in the assessment of the right ventricular function remains uncertain. Kaul and colleagues, taking advantage of the fact that there is normally substantial motion of the tricuspid plane in the meridional (longitudinal) direction, showed that this motion reflected right ventricular systolic function.7 8 More recently, a technique has been described involving atrioventricular motion dynamics, using pulsed Doppler cross sectional echocardiography.9 This allows assessment of ventricular performance in the meridional direction. Our aim in the present study was to assess right ventricular function using indices derived from tricuspid annular motion and compare the results with RVEF calculated from radionuclide angiography. METHODS Study populationThirty patients underwent radionuclide angiography for assessment of right ventricular ejection fraction. Immediately after the completion of the radionuclide study, all patients were submitted to pulsed Doppler cross sectional echocardiography. Blood pressure and heart rate were obtained before the echocardiographic study. Twenty patients were male (age range 29 to 77 years) and 10 were female (20 to 64 years). The patients were divided into two groups according to the right ventricular ejection fraction, measured by radionuclide angiography. Group 1 consist...

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Section: Possible Limitationsmentioning

confidence: 99%

Assessment of right ventricular function with Doppler echocardiographic indices derived from tricuspid annular motion: comparison with radionuclide angiography

Ueti

2002

Heart

239

174

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“…In fact, the modifying projection ratios due to systolic heart movements can alter the location of this point. The hypothesis of apical wall effacement [19,20] holds that the anatomical apex in systole cannot be identified angiographically . Nevertheless, the angiographic apex reflects the limit of the ventricular cavity in diastole and in systole and thus serves as a useful reference point.…”

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confidence: 99%

Quantitative regional contraction analysis of cineventriculography: Reporting, filing, and retrieval functions using a personal computer

Bozzi

Verna

Skinner

et al. 1989

Cathet. Cardiovasc. Diagn.

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A new method for the semiobjective evaluation of left ventricular wall contraction is proposed that uses a percent reduction of areas. The calculation model uses orthogonal coordinates, an internal reference system, and the concept of nonuniform reduction of the cavity, with its obliteration at the apex. From a normal patient population (ten males, four females; aged 45 +/- 13 years), a "normal reference curve" of contraction was obtained. A second patient group (56 males, two females, aged 56 +/- 7 years) with definite contraction abnormalities was then analyzed. A third group (eight males, one female, aged 56 +/- 10 years) was studied before and after nifedipine administration (1 mg over 2 min IV). Specific algorithms compare individual patient contraction curves with the normal reference curve and compute the score point system of contraction analysis. Data are automatically codified and filed during introduction. This saves time and allows a rapid retrieval of data grouped under different coded features. These features include the location and type of wall contraction abnormalities. This method of reading ventriculograms has been shown to be in accordance with the diagnosis of experienced observers and can detect small contraction changes that are induced pharmacologically. The method is proposed as a valuable tool for semiobjective evaluation of left ventricle wall contraction and to facilitate data collection in multicenter collaborative studies.

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